Effectiveness of an antihistamine-decongestant combination for young children with the common cold: A randomized, controlled clinical trial

The theme of the first consensus conference to be held in Finland was the treatment of acute otitis media. The statements and recommendations accepted by the conference, which was organized according to the National Institutes of Health model, are presented in this report. On the basis of scientific knowledge, clinical experience, and conditions in Finland, the conference delegates concluded that penicillin V, in large doses, is still the drug of first choice in this disease. The importance of surgical drainage of the middle ear was stressed, as was the necessity of careful follow-up of the patient until the condition is completely healed. Decongestants were considered rather useless. In the prevention of recurrent attacks, adenoidectomy but not tonsillectomy was regarded as being of help, tympanostomy of probable benefit, antimicrobial (sulfonamide) prophylaxis worth considering in selected cases, but the effect of pneumococcal vaccination poor. The conference delegates agreed that uncomplicated acute otitis media should, as before, usually be treated by physicians taking care of children at the primary health care level.

Finnish approach to the treatment of acute otitis media. Report of the Finnish Consensus Conference.

A randomized, placebo-controlled trial of the effect of antihistamine or corticosteroid treatment in acute otitis media☆

Background Acute otitis media ( AOM) is a common and important source of morbidity in children, although the majority of cases resolve spontaneously. While frequently recommended, decongestant and antihistamine therapy is of unclear benefit. Objectives To determine the efficacy of decongestant and antihistamine therapy in children with AOM on outcomes of AOM resolution, symptom resolution, medication side effects, and complications of AOM. Search strategy In this updated review, we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, Issue 2); MEDLINE ( January 2004 to May 2007); and EMBASE ( July 2003 to May 2007). Selection criteria Randomized controlled trials ( RCTs) evaluating decongestant or antihistamine treatment for children with AOM were included. Patient-oriented outcomes were considered most relevant. Data collection and analysis The review authors independently evaluated studies for inclusion, performed validity assessments and completed data extraction. Dichotomous data were pooled to generate relative risks; homogeneity was assessed using approximate chi-square tests. Main results No new studies were included following this updated search. Fifteen trials involving 2695 people were included. Only the combined decongestant-antihistamine group demonstrated statistically lower rates of persistent AOM at the two week period ( fixed relative risk ( RR) 0.76; 95% confidence interval ( CI) 0.60 to 0.96; number needed to treat ( NNT) 10). No benefit was found for early cure rates, symptom resolution, prevention of surgery or other complications. There was a five to eight-fold increased risk of side effects for those receiving an intervention, which reached statistical significance for all decongestant groupings. Validity sub analyses demonstrated that lower quality studies found benefit, while analysis of those studies with higher validity scores found no benefit of treatment ISSN/ISBN: 1469-493X WEB/URL: ISI:000257810900104;

Decongestants and antihistamines for acute otitis media in children

Side-effects of peroral mucous membrane decongesting agents have been described in recent years while at the same time documentation of the efficiency of these preparations is sparse. The prescription of the agents is very frequent. This article reviews the literature on the use of oral sympathomimetic agents for the treatment of diseases in the upper respiratory passages. The survey was initially instituted by the Swedish National Board of Health and Welfare to consider the indications for the prescription of these drugs. The article concludes with some suggested indications for these preparations.

Orally administered decongestant drugs in disorders of the upper respiratory passages: a survey of clinical results.

A clinical trial of antihistamine, decongestant, or placebo in antibiotic-treated acute otitis media followed with pneumatic otoscopy and impedance tympanometry.

Artalejo L rd

Papers

A clinical trial of antihistamine, decongestant, or placebo in antibiotic-treated acute otitis media followed with pneumatic otoscopy and impedance tympanometry.